Hair Loss Test Panel

This lab test panel includes main blood test markers involved in hair loss, including conditions like female pattern hair loss. Note: Some medications (listed below) may cause hair loss in men and women.

Anemia-related factors:

• Complete Blood Count (CBC)—Can detect potential low hemoglobin and infections that can lead to hair loss. Additionally, some CBC markers like MCV and MCH can detect B-12 and folate deficiency that affects hair growth.

• Ferritin: Low ferritin, an iron storage protein, has been linked to hair loss and slow down of hair growth.

• Iron and Total Iron Capacity (TIBC)—Low iron anemia has been linked to hair loss.

Hyperandrogenism: Excessive male hormones (androgens):

In healthy women, the ovaries and adrenal glands produce about 40% to 50% of the body’s testosterone. Tumors of the ovaries and polycystic ovary syndrome (PCOS) can both cause too much androgen production. High testosterone can lead to high dihydrotestosterone (DHT), a known factor in male and female hair loss. Cushing's disease is a problem with the pituitary gland that leads to excess amounts of corticosteroids and DHEA. In men with a genetic predisposition to hair loss, excess DHT may worsen this issue.

• Total Testosterone Test (LC/MS)

• Free Testosterone (Equilibrium Ultrafiltration)

• DHEA-S

• Dihydrotestosterone (DHT)

Hypothyroidism and Hyperthyroidism: Both low and high thyroid function are known factors in hair loss.

• Thyroid Stimulating Hormone (TSH)

• Free Triiodothyronine (Free T3)

Some vitamin deficiencies can also cause hair loss in men and women with poor dietary habits, malabsorption, and illness. Please check our discounted vitamin tests.

Understanding Hair Loss

Hair loss, medically known as alopecia, can be a distressing condition for both men and women. It can affect one’s self-esteem and overall quality of life. Hair loss can occur for various reasons, including genetics, hormonal imbalances, nutritional deficiencies, and certain medical conditions. Understanding the root cause of hair loss is crucial for effective treatment and management.

Hair Growth Cycle and Hair Follicles

Hair growth is a complex process that involves the coordinated effort of multiple cell types, hormones, and growth factors. The hair growth cycle consists of three phases: anagen, catagen, and telogen. The anagen phase is the active growth phase, during which the hair grows rapidly. This phase can last several years. The catagen phase is a short transitional phase that lasts a few weeks, during which the hair follicle shrinks and detaches from the dermal papilla. Finally, the telogen phase is the resting phase, lasting a few months, during which the hair is released from the follicle and falls out.

Hair follicles are the tiny tubes in the skin from which hair grows. Each follicle is surrounded by a cluster of cells called the dermal papilla, which play a crucial role in regulating hair growth. The hair follicle is also surrounded by a layer of cells called the inner root sheath, which helps to shape the hair shaft. Disruptions in the hair growth cycle or damage to the hair follicles can lead to hair loss. Factors such as hormonal imbalances, nutritional deficiencies, and certain medical conditions can trigger hair loss by affecting the hair growth cycle and the health of hair follicles.

Causes of Hair Loss: Androgenetic Alopecia

There are many causes of hair loss. Causes include certain diseases, chemical exposure, or drug use. The most common causes are:

• Androgenic Alopecia (AGA) - Male and Female Pattern Baldness, also known as “Androgenic Alopecia”, is the most common cause of hair loss and will affect up to 70% of men and 40% of women at some point in their lifetime. Men typically present with hairline recession at the temples and hair-loss on the upper surface of the head, also known as vertex balding. Women typically present diffuse, or scattered, thinning of the hair over the top of their scalps. People who suffer from this type of hair loss have an underlying sensitivity to “hair follicle miniaturization” due to androgenic hormones.

• Poor Nutrition - Usually complete baldness is not seen in people with nutritional deficiencies; thinning of the hair is more common. Studies show that limited food intake and deficiencies in certain nutrients can cause thinning. These include deficiencies of biotin, amino acids (protein), zinc, and iron. Consuming a diet high in animal fat, such as in fast food, can also have a negative effect on hair loss.

• Alopecia Areata - Alopecia areata is an autoimmune disease characterized by patchy hair loss. It is diagnosed through various blood tests that can identify underlying conditions such as inflammation and vitamin D deficiency.

• Hair Fall - Hair fall can be evaluated clinically to understand its underlying causes. Factors such as genetic predispositions, hormone levels, and nutritional deficiencies play a significant role in hair fall.

• Hair Loss in Women - Hair loss in women can be caused by hormonal imbalances, nutritional deficiencies, and genetic predisposition. Blood tests are crucial in diagnosing these issues and creating targeted treatment plans.

• Stress—Stress has been shown to restrict the blood supply to capillaries, which prevents oxygen and nutrients from reaching the hair follicle, thus preventing hair growth. Stress can also lead to hormonal imbalances that contribute to hair loss.

• Medications: Some medications can cause hair loss, especially medications that affect hormone levels. These medications include contraceptive pills, some forms of hormone replacement therapy, anabolic steroids, and acne medication. Other medications that can have an effect on hair loss include those for blood pressure, diabetes, heart disease, and cholesterol.

What is Hair Loss (Alopecia) from Medications?

Alopecia from drugs is a usually reversible, nonscarring, diffuse hair loss that occurs within days to weeks of starting a new medication or changing the dose, but in some cases, it can lead to permanent hair loss, particularly when associated with conditions like scarring alopecia.

Who Gets Drug-Induced Alopecia?

The development of hair loss and severity depends both on the drug and individual predisposition. Some drugs cause hair loss in most patients receiving an appropriate dose. Other drugs are only occasionally responsible for hair loss.

What Types of Hair Loss Caused by Medications Affect Hair Follicles?

There are two types of drug-induced hair loss:

Anagen effluvium—the shedding of actively growing hairs. Anagen effluvium is usually due to chemotherapy drugs and rarely with gold, colchicine, or poisoning with arsenic, bismuth, thallium, or boric acid.

Telogen effluvium—the shedding of resting, or bulb, hairs. Telogen effluvium is the mechanism of virtually all other medication-induced hair loss. The list of possible drug causes is very long and includes:

• Anti-coagulants

• Anti-hypertensives

• Hormones—oral contraceptive pill (during/after/changing), hormone replacement therapy, androgens.

• Anticonvulsants

• Mood stabilizers and antidepressants — most, such as lithium, 12–19%

• Others — some antipsychotics and anti-anxiety drugs

Male pattern baldness, a distinct form of hair loss, primarily affects men but can also occur in women to a lesser degree. Unlike hair loss caused by medications, male pattern baldness is a genetic condition characterized by a specific pattern of hair thinning and loss. Understanding the differences between male pattern baldness and other types of hair loss is crucial for accurate diagnosis and treatment.

Diagnosing Hair Loss

Diagnosing hair loss involves a comprehensive approach that includes a detailed medical history, physical examination, and various diagnostic tests. Blood tests are an essential tool in diagnosing hair loss. They can help identify underlying medical conditions, hormonal imbalances, and nutritional deficiencies that may be contributing to hair loss.

Blood Tests for Hair Loss

Blood tests provide valuable insights into the underlying causes of hair loss. They can help identify conditions such as anemia, thyroid disorders, and hormonal imbalances that can trigger hair loss. Here are some key blood tests used in diagnosing hair loss:

Complete Blood Count (CBC)

A complete blood count (CBC) is a blood test that measures the levels of different components in the blood, including red blood cells, white blood cells, and platelets. A CBC can help diagnose conditions such as anemia, which can cause hair loss. It can also help identify infections and inflammation, which can contribute to hair loss. By evaluating the overall health of the blood, a CBC provides essential information about potential underlying issues affecting hair health.

Thyroid Function Tests (TFTs)

Thyroid function tests (TFTs) are blood tests that measure the levels of thyroid hormones in the blood. The thyroid gland plays a crucial role in regulating hair growth, and an underactive or overactive thyroid gland can cause hair loss. TFTs can help diagnose conditions such as hypothyroidism and hyperthyroidism, which can contribute to hair loss. By assessing thyroid hormone levels, these tests can pinpoint thyroid-related issues that may be affecting hair growth.

In addition to CBC and TFTs, other blood tests that may be ordered to diagnose hair loss include:

• Hormonal Panel: This test measures the levels of different hormones in the blood, including testosterone, estrogen, and progesterone. Hormonal imbalances can significantly impact hair growth and lead to conditions such as androgenetic alopecia.

• Iron and Ferritin Tests: These tests measure the levels of iron and ferritin in the blood, which can help diagnose iron deficiency anemia, a common cause of hair loss. Adequate iron levels are essential for healthy hair growth.

• Vitamin and Mineral Tests: These tests measure the levels of different vitamins and minerals in the blood, including vitamin D, vitamin B12, and zinc. Nutritional deficiencies can weaken hair follicles and lead to hair thinning and loss.

By ordering these blood tests, healthcare providers can gain a better understanding of the underlying causes of hair loss and develop an effective treatment plan. Identifying and addressing these issues can help restore healthy hair growth and prevent further hair loss.

What are the treatments for hair loss due to hormonal imbalances?

Several treatments are currently being used for hair loss as prescribed medications or over-the-counter (OTC) options.

Rogaine (Minoxidil)

Unlike Propecia, Rogaine doesn't come with all the negative side effects. This OTC treatment is a topical one rather than oral, so it is applied directly to the scalp as a means of combatting hair loss.

How does it work? Rogaine helps to increase the flow of blood to your scalp and hair follicles, preventing the follicles from shrinking—basically jump-starting them and getting them back into working order. The topical treatment is very unlikely to interact negatively with oral medications, so it should be fairly safe for your use.

Low-dose oral minoxidil is showing some promise in growing hair in men and women.

Platelet-Rich Fibrin Matrix Injections

In 2014, a study was published in the journal Facial Plastic Surgery, detailing the results of using platelet-rich fibrin matrix as a means of treating hair loss.

Platelet-rich fibrin matrix (PFRM) is a mixture made by separating the red and white blood cells from the platelets and plasma. According to the Journal of the American Medical Association, "It is collected in a vacuum-sealed collection tube with a thixotropic separator gel, and the tube is centrifuged for 6 minutes at 1100 rpm. This process separates the red and white blood cells from the plasma and platelets, which are then transferred in a closed system to a second tube containing calcium chloride; it is this small amount of calcium that initiates the fibrinogen cleavage and the fibrin polymerization."

In the Facial Plastic Surgery study, 15 men and women with androgenetic alopecia were given injections of PFRM three times a month over the course of 1 year. During that time, their hair density indexes were monitored. After just 1 year, hair density indices increased significantly, meaning the patients' hair grew thicker and denser on the scalp.

Latanoprost

Latanoprost is a medication used to help regrow eyelashes that have fallen out as a result of thyroid disorders or stress. However, studies have shown that the hair regrowth benefits extend beyond just the eyelashes, but the medication can even help to replenish hair that has been lost from the head.

A 2012 study published in the Journal of the American Academy of Dermatology found that latanoprost "significantly increased hair density (terminal and vellus hairs) at 24 weeks." Essentially, it could help to stimulate activity in the hair follicles, making it a potentially effective treatment for hair loss.

Ketoconazole

Ketoconazole (KCZ), originally used for seborrheic dermatitis, dandruff (in Nizoral shampoo) and as an antifungal medication, has also been found to be effective in stimulating new hair growth when applied topically.  Even though the exact mechanism of topical KCZ for hair growth is not clearly understood, evidence suggests that ketoconazole acts as an androgen receptor suppressor.

Progesterone

Progesterone is a critical hormone produced by the female body. Progesterone acts as a precursor in the production of other vital hormones, such as estrogen and cortisone.

Topical progesterone-based hair restoration therapy is demonstrably effective in treating hair loss, according to multiple studies. It's believed that progesterone acts by inhibiting an enzyme called 5-alpha reductase, the enzyme needed to convert testosterone into DHT. Specifically, progesterone will prevent DHT from forming in the first place by blocking the action of 5-alpha reductase.

Certain other studies have also suggested that progesterone could have a significant effect on human hair growth beyond its ability to prevent testosterone from converting into DHT.

Higher levels of estrogens during pregnancy are thought to be the reason for an increase in the ratio of hair follicles in the growing phase of the female hair growth cycle. It's also true that after giving birth (when progesterone levels decrease), these new follicles enter a resting phase that results in increased hair shedding and temporary hair thinning.

Spironolactone

Spironolactone is a powerful androgen receptor blocker, and when applied topically, it can prevent DHT from attaching to both hair follicles and oil glands.

Spironolactone can effectively prevent DHT from binding to androgen receptors in your follicles and stimulating your body's immune response to attack your own hair. Although the reason for this isn't clearly understood, topical spironolactone is a scientifically verified way to stop DHT from causing a follicle-destroying immune response.

Topical Combination Hair Loss Products

Compounding pharmacies make topical scalp solutions to treat hair loss containing a combination of several of the options mentioned above.